Shanbhag A S, Jacobs J J, Black J, Galante J O, Glant T T
Department of Orthopaedic Surgery, Rush-Presbyterian, St. Luke's Medical Center, Chicago, Illinois 60612, USA.
J Arthroplasty. 1995 Aug;10(4):498-506. doi: 10.1016/s0883-5403(05)80152-4.
The interfacial membrane between implant and host-bone in aseptically loose total hip arthroplasties has a potential role in the etiology of local bone resorption and loosening of the prosthetic component. Inflammatory/potential "bone-resorbing" agents (cytokines/mediators) released by the cells of the interfacial membranes of loosened uncemented and cemented total hip arthroplasties were measured. Synovial tissues from patients with acute femoral neck fractures, patients with osteoarthritis, and cadavers without joint disorders were used as control subjects. Control synovial tissue from osteoarthritic patients secreted the highest levels of prostaglandin E2, interleukin-8, and tumor necrosis factor alpha. Interleukin-1 alpha was the only cytokine whose levels were elevated as much as 4-fold around uncemented implants compared with cemented implants, and up to 16-fold compared with control synovial tissue. An apparent inverse relation between interleukin-1 alpha and interleukin-6 interfacial membranes of total hip arthroplasties compared with control synovial tissues suggests a complex cellular mechanism through a cytokine/prostaglandin cascade; this may regulate the observed bone resorption in aseptic loosening.
在无菌性松动的全髋关节置换术中，植入物与宿主骨之间的界面膜在局部骨吸收和假体部件松动的病因学中具有潜在作用。对松动的非骨水泥型和骨水泥型全髋关节置换术界面膜细胞释放的炎性/潜在“骨吸收”因子（细胞因子/介质）进行了测量。将急性股骨颈骨折患者、骨关节炎患者以及无关节疾病的尸体的滑膜组织用作对照。骨关节炎患者的对照滑膜组织分泌的前列腺素E2、白细胞介素-8和肿瘤坏死因子α水平最高。白细胞介素-1α是唯一一种细胞因子，与骨水泥型植入物相比，其在非骨水泥型植入物周围的水平升高了4倍，与对照滑膜组织相比则高达16倍。与对照滑膜组织相比，全髋关节置换术界面膜中白细胞介素-1α和白细胞介素-6之间明显的负相关关系表明，通过细胞因子/前列腺素级联反应存在一种复杂的细胞机制；这可能调节了无菌性松动中观察到的骨吸收。
